Student Registration Form - Buffalo Trail Public Schools ...

Student Registration Form

ASN:

201.6AP Exhibit 3

(Completed by School Office Staff)

This registration form is a legal document. Before a student can be admitted by a school, a student registration form must be completed in its entirety. Our staff will be pleased to assist you. The information requested on this form is being collected pursuant to the School Act, Section 23, A.R. 225/2006 and the FOIP Act, Sections 33(c), 39(1)(b) & 40 (1)(c). Information acquired through this form is kept secure and access is restricted.

During the ______-______ school year, my child will attend _______________________ School.

*New registrants to Buffalo Trail Public Schools must provide the school with a copy of the student's birth certificate for proof of legal name and date of birth. If for some reason this document cannot be provided, please discuss alternate options with the office staff.

Has your child previously attended a school in Buffalo Trail Public Schools (BTPS)? _____Yes _____No If yes, which school? _______________________________

School History: Last School attended: School Name ___________________________________________________________________ School Address (City, Province) _____________________________________________________ Date Last Attended (month/day/year) ______________________ Grade Level at Previous School _____

If registering from out of province, has the student ever attended school in Alberta? _____Yes _____No

Is the student currently under an expulsion order from any school jurisdiction that has not been resolved or concluded? _____Yes _____No

If the expulsion is ongoing, please contact Students Online School at 780-847-3639 Please refer to BTPS Admin Procedure - 202.9AP

Student Information

Legal Surname: _____________________________________________________________ Legal First Name: ____________________________________________________________ Legal Middle Name(s): ________________________________________________________

June 15, 2018

201.6AP Exhibit 3

Does the student wish to be called a name different from the legal name? _____Yes _____No If yes: AKA Surname: _______________________________

AKA First Name:______________________________

Gender: _____ Male

_____ Female

_____ Unspecified

Date of Birth (month/day/year): ___________________________________ Country of Birth: _______________________________________________

Grade Level Entering: __________ School Enrollment Starting Date (month/day/year): ___________________________

Siblings attending the same school: ________________________________________ ________________________________________ ________________________________________

Student Mailing Address:

Box/Street __________________________________________ City, Province __________________________________________ Postal Code __________________________________________

Student Physical Address: Is this the same as the mailing address? _____Yes _____No

If No:

Legal Land Location/911 Address___________________________

OR Residential Address __________________________________

__________________________________

Phone number to call in regard to this student: _______________________________________

(Used for attendance, emergencies, etc.)

This phone is a: _____ Landline _____Cell

Student Medical Information: Are there any medical conditions you wish the school to be aware of? Please provide details: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

*Note: If your child has a severe and/or life threatening allergy or medical condition, please contact the principal to develop a medical plan as per BTPS procedures: 203.1AP Administration of Medication/Medical Assistance to Students.

June 15, 2018

201.6AP Exhibit 3

Student Special Needs Information: Does your child have any physical, intellectual, behavioral or emotional needs which may require additional educational assistance beyond the regular educational programming? _____Yes _____No If yes, please give details:_________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Citizenship Information (Completed by School Office Staff)

_____ Code 1-Canadian Citizen (student was born in Canada) ? request a copy of the student's birth certificate

_____ Code 2-Permanent Resident (student has a PR Card) ? request a copy of the student's birth certificate, the student's passport and the student's PR Card; take note of the expiry date on the PR Card (submit this documentation to the SIS Department)

_____ Code 5-Temporary Resident-Student (Unfunded Visiting Student-Not on a Reciprocal Exchange) ? request a copy of the student's birth certificate, Citizenship and Immigration Canada document (student visa/study permit/electronic travel authorization), two character reference letters, statement of good health from a physician, recent report card; enter the expiry date of the Citizenship and Immigration document in the SIS software and assess tuition fees

_____ Code 5-Temporary Resident-Student (Unfunded Visiting Student-On a Reciprocal Exchange) ? request a copy of the student's birth certificate, a copy of the exchange information; the document expiry date in the SIS software is one day after the student is leaving the school, do not assess tuition fees (submit this documentation to the SIS Department)

_____ Code 6-Child of a Canadian Citizen (One or both parents are Canadian citizens, but the student was born outside Canada) ? request a copy of the student's birth certificate and a copy of the parent(s) birth certificate or the parent(s) Certificate of Canadian Citizenship

_____ Code 7-Child of a Resident (One or both parents are in Canada on a work permit) ? request a copy of the student's birth certificate, the student's passport, student's study permit or visitor record and the parent(s) work permit; take note of the expiry date on the work permit (submit this documentation to the SIS Department)

_____ Code 9-Other/Unknown (Step Child of a Canadian Citizen) - request a copy of the student's birth certificate, the student and foreign parent passport, the student's study permit and proof that permanent residence has been applied for and the associated fee has been paid (submit this documentation to the SIS Department)

June 15, 2018

Parent/Guardian Information

201.6AP Exhibit 3

(A) Parent/Guardian Name: __________________________________________ Relationship to Student: ____________________________ Mailing Address: Box/Street __________________________________________

City, Province __________________________________________ Postal Code __________________________________________

Physical Address:

Is this the same as the mailing address? _____Yes _____No

If No: Legal Land Location/911 Address_____________________ OR

Residential Address ______________________________ ______________________________

Home Phone: __________________________________________ Cell Phone: __________________________________________ Work Phone: __________________________________________ Email Address:____________________________________ (used to send school and Parent Portal info)

Does this student live with you? _____Yes _____No

(B) Parent/Guardian Name: __________________________________________ Relationship to Student: ____________________________ Mailing Address: Box/Street __________________________________________

City, Province __________________________________________ Postal Code __________________________________________

Physical Address:

Is this the same as the mailing address? _____Yes _____No

If No: Legal Land Location/911 Address_____________________ OR

Residential Address ______________________________ ______________________________

Home Phone: __________________________________________ Cell Phone: __________________________________________ Work Phone: __________________________________________ Email Address:____________________________________ (used to send school and Parent Portal info)

Does this student live with you? _____Yes _____No

June 15, 2018

201.6AP Exhibit 3

(C) Parent/Guardian Name: __________________________________________ Relationship to Student: ____________________________ Mailing Address: Box/Street __________________________________________

City, Province __________________________________________ Postal Code __________________________________________

Physical Address:

Is this the same as the mailing address? _____Yes _____No

If No: Legal Land Location/911 Address_____________________ OR

Residential Address ______________________________ ______________________________

Home Phone: __________________________________________ Cell Phone: __________________________________________ Work Phone: __________________________________________ Email Address:____________________________________ (used to send school and Parent Portal info)

Does this student live with you? _____Yes _____No

(D) Parent/Guardian Name: __________________________________________ Relationship to Student: ____________________________ Mailing Address: Box/Street __________________________________________

City, Province __________________________________________ Postal Code __________________________________________

Physical Address:

Is this the same as the mailing address? _____Yes _____No

If No: Legal Land Location/911 Address_____________________ OR

Residential Address ______________________________ ______________________________

Home Phone: __________________________________________ Cell Phone: __________________________________________ Work Phone: __________________________________________ Email Address:____________________________________ (used to send school and Parent Portal info)

Does this student live with you? _____Yes _____No

June 15, 2018

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